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Simple pneumonia & pleurisy w CC

MS-DRG 194 · negotiated-rate distribution across hospitals in NY

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Hospitals
12
Min
$7,704.78
Median
$10,719
Max
$25,329
Range multiplier
3.3×

By payer (43 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna1126$2,892$15,583$27,5399.5×
Empire BCBS525$6,136.61$18,572$315,75951.5×
UnitedHealthcare923$2,276$10,649$315,759138.7×
Emblem Health619$8,351.13$16,803$315,75937.8×
Cigna717$8,351.13$20,016$315,75937.8×
Blue Cross Blue Shield510$663.07$8,262.4$13,99621.1×
Humana88$7,949.96$8,819.73$315,75939.7×
oxford47$2,276$23,637$315,759138.7×
Medicare27$6,439.47$7,949.96$7,949.961.2×
WellCare77$7,860.42$9,025.57$315,75940.2×
Healthfirst46$8,693.28$11,538$315,75936.3×
fidelis55$8,518.15$11,418$315,75937.1×
mvp45$2,855$8,747.27$11,4184.0×
geisinger health plan24$8,351.13$13,841$20,0072.4×
magnacare44$3,506$20,339$31,1808.9×
cdphp24$8,351.13$18,629$29,7503.6×
oscar34$17,296$17,296$19,8911.2×
local 119933$17,575$21,663$24,1771.4×
vns33$11,418$11,659$315,75927.7×
horizon12$19,383$21,093$22,8031.2×
1199 seiu22$8,306.41$8,588.21$8,8701.1×
health first22$8,351.13$8,621.66$8,892.191.1×
Medicare Advantage12$5,076$6,005.15$6,934.291.4×
upmc22$8,351.13$8,621.66$8,892.191.1×
metroplus22$11,659$163,709$315,75927.1×
st. regis11$8,747.27$8,747.27$8,747.271.0×
TRICARE11$4,109.35$4,109.35$4,109.351.0×
brighton11$23,468$23,468$23,4681.0×
VA Health11$8,747.27$8,747.27$8,747.271.0×
1199seiu national benefit funds11$12,466$12,466$12,4661.0×
elderplan11$315,759$315,759$315,7591.0×
elderplan 131611$7,949.96$7,949.96$7,949.961.0×
emblemhealth11$9,578.42$9,578.42$9,578.421.0×
centers plan for healthy living11$11,418$11,418$11,4181.0×
fidelis care11$8,747.27$8,747.27$8,747.271.0×
capital district physicians' health plan11$8,747.27$8,747.27$8,747.271.0×
longevity11$8,693.28$8,693.28$8,693.281.0×
capital district physicians health plan mcr adv11$7,704.78$7,704.78$7,704.781.0×
wellpath11$13,121$13,121$13,1211.0×
northwell direct11$17,730$17,730$17,7301.0×
capital district physicians health plan cdphp11$7,704.78$7,704.78$7,704.781.0×
partners health plan11$11,418$11,418$11,4181.0×
prime health services11$8,892.19$8,892.19$8,892.191.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
NASSAU UNIVERSITY MEDICAL CENTEREAST MEADOWNY6$7,490.7$9,949.08$13,278
GARNET HEALTH MEDICAL CENTERMIDDLETOWNNY17$8,892.19$8,892.19$31,180
CHAMPLAIN VALLEY PHYSICIANS HOSPITALPLATTSBURGHNY10$8,269.67$8,747.27$19,654
GARNET HEALTH MEDICAL CENTER - CATSKHARRISNY15$8,351.13$8,351.13$30,123
FREDRICK FERRIS THOMPSON HOSPITALCANANDAIGUANY6$7,949.96$6,216.71$7,949.96$10,649
ADIRONDACK MEDICAL CENTERSARANAC LAKENY8$21,025$13,035$663.07$7,704.78$8,255.12
NEW YORK EYE AND EAR INFIRMARYNEW YORKNY15$8,306.41$25,329$315,759
MEMORIAL HOSPITAL FOR CANCER AND ALLNEW YORKNY3$17,418$21,472$34,467
NEW YORK PRESBYTERIAN HOSPITALNEW YORKNY15$11,659$19,891$31,752
SOUTH NASSAU COMMUNITIES HOSPITALOCEANSIDENY12$6,136.61$17,296$31,129
ST. JOSEPHS MEDICAL CENTERYONKERSNY14$55,331$2,276$11,418$27,461
ELIZABETHTOWN COMMUNITY HOSPITALELIZABETHTOWNNY1$10,719$10,719$10,719

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.